Pediatric trauma in sub-Saharan Africa: Challenges in overcoming the scourge
InformAfrica – According to information published by the Journal of Emergencies, Trauma, and Shock (JETS) by five African medical researchers: All over the world, pediatric trauma has emerged as an important public health problem. It accounts for the highest mortality in children and young adults in developed countries.
Reports from Africa on trauma in the pediatric age group are few and most have been single center experience. In many low-and middle-income countries, the death rates from trauma in the pediatric age group exceed those found in developed countries. Much of this mortality is preventable by developing suitable preventive measures, implementing an effective trauma system and adapting interventions that have been implemented in developed countries that have led to significant reduction in both morbidity and mortality.
This review of literature on the subject by pediatric and orthopedic surgeons from different centers in Africa aims to highlight the challenges faced in the care of these patients and proffer solutions to the scourge.
Pediatric trauma is a common cause of morbidity and mortality. It is the most likely cause of death in children who survive the first five years, when infectious diseases are the leading cause of death; and this continues till the fourth decade of life.
In some countries, the mortality from pediatric injuries is more than 50%. In many low-and middle-income countries, the death rates from trauma in the pediatric age group exceed those found in developed countries. Much of this mortality is preventable by implementing an effective trauma system and developing interventions that have been implemented in developed countries and led to significant reduction in both morbidity and mortality.
The challenges of pediatric trauma in Africa and particularly in sub-Saharan Africa will be highlighted by considering:
(i) the burden of trauma among pediatric populations,
(ii) the role of sociopolitical will in addressing the problem,
(iii) challenges of developing trauma centers in developing economies,
(iv) the funding of such centers,
(v) the challenge of personnel training
(vi) the challenge of educating the public; that injuries are preventable public health problems that should be addressed as such and finally proffer the possible solutions to these challenges.
The burden of trauma in Africa
Africa has been described to be the least healthy place in the world to live. The infant and maternal mortality rates in African countries are among the highest in the world. The average annual per capita income is in the range of $400 or less. As far back as 2 decades ago, about 36% of the urban population and 75% of the rural population live below the absolute poverty line. The average per capita expenditure spent on health in most sub-Saharan African countries is less than $14 per annum.
Against this background is the attempt by most governments to industrialize their nations with the attendant increase in the influx of motorized machines, cars and motorcycles. This has increased the incidence of trauma in these countries including pediatric trauma, and trauma is fast becoming a leading cause of death among the pediatric age group of 0 – 15 years.
This epidemiological profile is similar to the situation in most high-income countries of the world, where injuries are the most common cause of death in this age group.
The exact scope of the burden of pediatric trauma in Africa is difficult to ascertain, as there are very few reports about this emerging public health problem. Most of the available records are from hospital-based data and inference from such reports is difficult to extrapolate to the general population.
One of such studies from southwest Nigeria showed that 9% of emergency room admissions were due to trauma in the pediatric age group. Another study from Ethiopia showed an injury rate of 4.8% among 7055 hospital admissions over a five-year period. Reports from certain areas of the continent have similar epidemiological profile as the developed countries of the world. For example, reports from Southern Africa and Mediterranean countries show that trauma is the most common cause of death in the age bracket of 0 – 15 years.
Read the full health study here: Pediatric trauma in sub-Saharan Africa: Challenges in overcoming the scourge
This global report is provided courtesy Journal of Emergencies, Trauma, and Shock for educational purpose.